Is their wisdom in becoming a psych nurse if the nurse has his own psych history?

Since age 18 (I'm now 31), I have suffered from depression and anxiety. I received one non nursing baccalaureate degree in 2005, had a failed semester at law school (I attribute this to the depression) and then got my BSN on August of 2012. I am currently working at my first nursing job on a neuro/med-surg floor.

My initial goal when entering nursing school was to become a mental health np. However, during my junior year of nursing school, I had a hypomanic episode (my first) and was hospitalized for six days. Currently I'm on more effective meds and doing just fine, now having a diagnosis of type II bipolar disorder. I mostly deal with depression, and am seeing a psychiatrist whom I like and trust.

My question to you all is this: would my personal experiences as a psych patient work well for me as a psych nurse? I didn't precept in nor pursue a job in mental health because I was concerned it would be a constant negative reminder of how painful this disorder had been for me growing up.

But the more that I've been a med-surg nurse (albeit for only a few short months), I wonder if maybe psych nursing isn't the route I should have taken.

What are your thoughts on this? Good idea or bad? Would I be 'too close' personally?

It's a very personal choice. A lot of nurses with psych hx purposely choose not to work in psych, because, as you note, it cuts a little too close to the bone for them. On the other hand, a surprising number of significantly dysfunctional people (with or without a "formal" psych history) seem to end up working in psych (mostly in unlicensed type roles, but also a surprising number of licensed professionals) and it often appears (from the outside) to be because they are, on some level, conscious or unconscious, seeking to get their own needs (for treatment, support, etc.) met. I've worked with quite a few people over the years who fit that description, and, lemme tell ya, that doesn't work for anybody -- them, clients, other staff, administration ... Then, there are people with experience on "the other side of the couch" who choose to work in psych for the same reasons anyone else does and do a fine job. Those individuals keep their personal business (like personal psych hx) to themselves, which is the professional and therapeutic thing to do in that circumstance.

I don't hear anything in your post about feeling drawn to psych nursing, just that you're wondering whether you "should" pursue it. Is this something that you want to do, that interests and engages you professionally? You have no kind of personal or professional obligation to work in psych just because you have personal experience, and psych units/facilities aren't going out of their way to look for staff with psych backgrounds. It's entirely up to you.

Best wishes for your journey!

Last edit by elkpark on Jan 10, '13

Jan 10, '13

As a patient, I think I'd feel more comfortable with a psych nurse who could empathize a little with what I was going through, than someone who learned everything from a textbook. A lot depends on their bedside manner, of course, and whether they have a passion for the field.....not everyone does.

I've never been hospitalized for my bipolar, but if it were to happen I'd want a nurse who's got a few issues and is open about them, but who's stable on meds---that would give me something to work toward. I don't know if this is the right move for you, but if you're thinking about it, I wouldn't let the fact that you have a mental health diagnosis get in the way of pursuing it.

As a patient, I think I'd feel more comfortable with a psych nurse who could empathize a little with what I was going through, than someone who learned everything from a textbook. A lot depends on their bedside manner, of course, and whether they have a passion for the field.....not everyone does.

I've never been hospitalized for my bipolar, but if it were to happen I'd want a nurse who's got a few issues and is open about them, but who's stable on meds---that would give me something to work toward. I don't know if this is the right move for you, but if you're thinking about it, I wouldn't let the fact that you have a mental health diagnosis get in the way of pursuing it.

Your first sentence sounds like you're suggesting that the only individuals capable of empathizing with what you would be going through would be those who have shared your same experiences. Nurses don't have to have shared the exact same experiences/illnesses/injuries as their clients in order to be able to empathize with their situations. I'm sure you've cared for countless people with illnesses or injuries you have never personally experienced, yet you were able to empathize with their situation enough to be therapeutic and provide high quality care.

As for psychiatric nurses being "open" about their own issues with clients, you may feel that is something you would find helpful, but it is considered highly unprofessional and nontherapeutic in psychiatric nursing (as well as the other mental health disciplines). Anyone who did much of that would soon be getting counseled about it. Our focus in clinical settings is on the client, not our own "stuff," and disclosing anything about our own issues at work is shifting that focus from the client to ourselves.

Jan 10, '13

^^ Looks like we were typing at the same time.

The temptation for many people who go into a particular specialty after personal experience is always to share, to let the patients feel your empathy, to let the patients know, "I understand what you're going through, I've been there." The problems there are twofold.

One, no matter how empathetic you are, you are NOT experiencing the situation they way the patient is. It is presumptuous to assume otherwise.

Two, it is totally not about you. It is inappropriate for you to insert yourself and your experiences into the patient's care situation.

So please bear this in mind as you journey to your decision about nursing in general and psych nursing in particular.

Last edit by nurseprnRN on Jan 10, '13
: Reason: oops. missed that you have graduated

Jan 10, '13

You two make excellent points. I'm looking at the topic as a patient, not as a nurse, and you are both right. Thank you.

Jan 10, '13

You all bring up excellent points. I do not want to introduce my own 'baggage' into a professional relationship with clients whether at my current job or in a potential career as a mental health nurse. I was always trained not to do this, and I frankly find it counterproductive to my job. If I'm talking about my problems then I'm not listening to my patient's.

I don't necessarily think I should go into mental health nursing just because I have type two bipolar disorder; rather I feel as though I abandoned my initial goal of doing psych work when I was hospitalized. If you have read my last thread, you know that I'm a new nurse who is not especially enamored with the med-surg work he's doing. I took the med-surg job after I was hospitalized because I had shelved my initial desire to do psych work. I wasn't sure what other area to pursue, and med-surg seemed like a good place to at least start my career, so here I am.

There are two things that concern me about doing psych work. The first was already touched on: I was very successful in my psych clinical rotation teaching classes because I usually started off by telling the patients about my experiences as a patient myself. Compared to my fellow students, the patients always listened to me the most, and were the most engaged during the classes and activities I led. But as a nurse, I'm not comfortable doing that. It takes away from the client's issues and focuses on me. I don't want that.

The second issue is more about skills. My friend is a psych nurse and she doesn't start IV's, or do any of the 'fun' nursing stuff. Only assessments And when she floats to other floors, she is more like a nursing assistant. And I don't want that. I learned these skills and typically enjoy doing them. If prefer not to lose them.

I don't know; maybe this isn't that big of a deal. When I started nursing school, I had a goal, and now that I've deviated from the original plan, I feel kind of lost as to where I want to end up in nursing.

Jan 11, '13

Those lab check-off "skills" that people are so focused on, especially while they are students and in their first year or two, are not nursing skills. They are just psychomotor skills that we teach lay people all the time. If you learned them once and forgot them or got rusty on them, you'd just learn them again if you ever had to. No biggie there. So what if your friend is like an aide when she floats to the floor? How many of those "skilled" nurses would give their eyeteeth for a break day of being "just" an aide? And how many of them aren't expert at what the psych nurses do when they float to psych? Oh, they don't float to psych because that's a specialized skill set? Mmmmm, imagine that.

See, nursing skills are those that only nurses can do. If you like psychosocial aspects of nursing plus the IVs-and-tubes thang, consider a med/surg unit in a busy county or city hospital where many of the patients need psych care too-- and won't usually get much of it, even from you, because you won't have time. If you crave psych nursing, then do psych nursing-- and you won't get much of the IVs-and-tubes thang. Or try a bulemia unit-- there's IVs-and-tubes for ya, but big psych.

As to where you'll end up in nursing, well, they say the gods listen to your plans and laugh. I doubt there is one experienced nurse on AN who is where s/he thought s/he would be at your point in his/her career. As for me, the last three jobs I had didn't exist when I was a year or two out of school; my career path was a totally blank map and I didn't even know it.
Inertia is your enemy, though, if you tend to get paralyzed by decision-making. I'd say to keep doing what you're doing, if only for the sake of doing something. I'm not sure that your dilemma is such a big deal, but you're the one living it. If you really need to change, then something will happen, and you will.

Jan 11, '13

Some of us who are psych nurses have maintained at least basic skills -- I have done just enough med-surg over the years (and I am an old diploma grad, so I was trained right in the first place ) that I can still do IVs, catheterizations, sterile dressing changes, etc., if need be. It's not necessarily an "either/or" situation. Also, nowadays there is a heckuva lot of psych on med-surg floors and a surprising amount of med-surg on psych units. I work in C&L in a big academic medical center where staff on the med-surg floors complain all the time about how many psych clients they have on their unit, and the psych units complain about how they're expected to take people with significant medical problems. The nurses who really shine (and have the easiest time of it) are the limited number who are comfortable (to some extent) in both "worlds."

Jan 12, '13

Thanks all for your thoughtful responses. I read and reread each one .

Obviously as a new nurse, I have a lot to learn, but hopefully I will also enjoy options as I get further along in my career. When I took my mental health course , the instructor told my class that what we learn about psych is applicable to every area of nursing, virtually; patients with psychiatric issues need care on virtually every level. I agree. I have worked with many clients who are addicts, or suffer from a slew of mental and emotional issues. In a way, I'm getting a good psych education where I'm at.

I did not mean to insult anyone with regards to the use of 'nursing skills' by psych nurses; it is a situation that I had been told about by other nurses in psych, so I expressed it here. I'm happy that it wouldn't be a problem to relearn them if need be.

Thanks again!

Jan 12, '13

While psych nursing interests me, I chose NOT to do it because of my own experiences being a psych patient. Just too close to home. Plus, I love ICU

However, there are a lot of people in the psych field with their own psych histories, be it psychiatrists, nurses, NP/PAs, techs, secretaries, OT, counselors, case managers, whatever. I think that having been on the other side of it CAN give you an edge, you know more closely what the patients are going through, and can give them more closely what they need in some of the worst times of their lives. *This is not to say that psych nurses without a psych history can't do this.* Either way, do what will make you happy. If you're worried about losing skills, get a per diem psych job, or keep your med/surg job per diem. I wish you luck on your journey

Jan 12, '13

Only you can answer if you would be happy in psych nursing. I will give you a few caveats though:

1. Your having prior psych experience does not guarantee that you will be a successful psych nurse, no more than having given birth would guarantee that you'd be a successful L&D nurse, having beaten cancer would guarantee you a successful career in oncology nursing, etc.

I know a lot of good psych staff that have MH issues. Yes, you may be able to relate a little better with your patient population d/t your experience, but your personal experience is only one small nugget of info in a very broad specialty. In addition, YOUR experience with a particular MH disorder doesn't mean a patient with the same d/o will have the same experience as you: they can be very very different.

Nor is not having a psych history mean that you'd automatically fail in the job. I know a lot of good psych staff w/o MH issues. Often, they can see things more objectively than someone who has "been there, done that."

2. A lot of people come into psych seeking to address unresolved issues in THEIR OWN mental health. Problem is that many of them can't separate their own mental health issues from that of their patients--they personalize the patient's MH problems and only see them through their own POV. Or they try to foist their own beliefs and attitudes on the patient. Or they spend more time seeking answers for their own issues and not focusing on their patients. End result: all parties lose out.

I worked with an addictions nurse who had decades of sobriety--very knowledgable, very skilled, and having "been there, done that" could relate with the population. But the problem was that this nurse couldn't keep their own recovery separate from their patients', and every issue with the patient became all about this nurse in the nurse's mind. Said nurse failed to realize that the patients' recovery is all about THE PATIENT, not about THE NURSE.

You honestly can't view working in psych nursing as a form of therapy/treatment for yourself. I'm not saying you are doing that...but be honest with yourself about what you're seeking in psych.

3. Would working in psych jeapordize your own MH in any way? You verbalize fear that it could be a "constant negative reminder" of your own d/o...like elkpark said, is there a risk that something in psych would hit too close to home to you? Remember, your MH recovery must always come first and foremost. And your patients need to come before you.

If you do decide that you want to try psych, you could always try out a per-diem or non-nursing job in the field first and see how you handle it. However, I would NOT disclose your own psych history as part of the job-hunting process. First, it's not going to be an "ace in the hole" that will get you a psych job. Second, a facility may wonder if they would be taking a chance with you, especially if they've had negative experiences with staff with MH issues in the past.

Best of luck whatever you decide!

Jan 16, '13

I am a mental health nurse, and this is what I have come to believe: A bit of history...after (currently) working five years in level one psych (highest acuity in this state/locked unit/independently standing, so no in-house medical resources, etc...) night shift charge nurse position; & four years booking assignments through a nursing agency, working in dual-diagnosis/straight substance dependency/corrections facilities primarily.

You're own experiences will ABSOLUTELY serve to make you a better, more empathetic and more SYMPATHETIC nurse, certainly. You will have a unique "insiders" view to some aspect of everything you see in those patients who share your diagnosis, and thar can be wonderful for the patient.

I don't believe it is necessarily ethical for you to share your history with acutely ill clients IN YOUR PLACE OF EMPLOY. Others will no doubt disagree, but I feel that it puts you at risk for legal action (sadly, in this day and age, psychiatric clients often are looking for an "edge", an "in" on the mental health employee caring for them. I could elaborate and certainly will if you like, but for the moment, I'll leave you with this...

IF you choose psychiatric nursing as your specialty, and you want patients to know you "get them"/their histories/etc...do so by sharing that you have a choose family member with their diagnosis. Explain that you understand through living that person that, "X, Y, & Z can be very challenging aspects of living with bipolar disorder...". It achieves the same goal you are looking to achieve, but does not compromise you legally or ethically.

Finally, if you really think about it, you will come to the conclusion that you CAN PROVIDE the very same ethically empathetic, sympathetic, and EXCELLENT care without that client ever knowing your history at all...and that, honestly, us what nursing is all about...THEM. Not you at all! Just some ideas to mull over.

Very best of luck to you. Again if you are interested, I'd definitely like to post OR PM you with some other info about the choices you are considering! Let me know! :0)